Novel Risk Factors of Coronary Heart Disease in Chronic Hemodialysis Patients

Backgrounds: Coronary heart disease (CHD) is the most common cause of mortality/or chronic hemodialysis (HD) patients, ‘et the risk factors for CHD have not been well established. Methods: We conducted a multi-center cross sectional survey to investigate the prevalence of CHD and its associated risk factors in 995 chronic HD patients recruited front twelve HD centers in Taiwan. Patients had discontinued taking lipid-lowering agents for at least two weeks before entry. We calculated prevalence of CHD and studied the association between it and thirty different possible risk factors. Results: In total, we studied 995 patients (M/F: 499/496) with a mean age of 56.4±12.3 years having undergone HD for ass average of 59.8±51.2 months. Lipid profiles showed cholesterol 179.4±44.5 mg/dL, triglyceride 173.6±145.0 mg/dL, high density lipoprotein cholesterol 40.9±13.2 mg/dL, and lose-density lipoprotein cholesterol 89.4±38.6 mg/dL. CHD, diabetes and hypertension prevalence rates were 24.0%, 24.1% and 61.0%, respectively. Results of our multivariate logistic regression analysis showed that, of the conventional CHD risk factors in the general population, only old age could he significantly associated with CHD. However, we did find some new possible risk factors for CHD-low apolipoprotein A-1 and creatinine levels, left ventricular hypertrophy, and cardiothoracic ratio≥55%. Conclusions: Our study suggests that not all of the conventional CHD risk factors for the general population can be considered risk/actors/or chronic HD patients, and there are others that mi gist contribute to a higher risk of CHD.